Generalization is the key to learning any new skill. We haven’t truly learned a new skill until we can perform that skill in a variety of situations. Generalization can be a tricky piece of the puzzle for those who use AAC. We can easily get stuck in a rut when it comes to treatment ideas and the goals we are targeting in sessions. If you feel like you or your client are losing interest, it’s time to change things up! Not only are the ideas below great for generalization, but when we take AAC out of the clinic and into the real world we show the AAC user, and those they interact with, that AAC is a valuable form of communication.
If you are in a hospital or clinic setting:
People have very strong feelings about AAC, love it or hate it. I often come across clinicians who want to use and learn more about AAC, but they all have stories of trying and failing, or being the only one on the team willing to use the device, or constantly lugging the device out of the student’s backpack. Then there are the stories of families who seem so gung-ho to begin, but once they discover AAC is not a quick fix or miracle cure, lose interest in using the device with their child. I have known clinicians who focused on AAC for many years of their careers only to get so fed up with all the obstacles that they stop using AAC too. With all the barriers to access, teaching, getting the team on board, and generalization of skills, why do we even bother??
It feels like something we shouldn’t say (I want to give up, AAC is too much trouble). It’s hard to bump up against these obstacles day after day without feeling discouraged. I have wanted to give up too, but one thing keeps me going. The small wins and little success stories. I’ll share 2 small wins that I think about often when I’m feeling discouraged.
I was 3 years out of grad school and working as an AAC specialist with little inkling of what I was doing. My job was going into classrooms in my territory (3 counties) to make sure kids who needed AAC had the device they needed, train staff, and consult with SLPs. I had one particularly ornery special education teacher on my caseload. She had been teaching for over 20 years, I was a young pup, and she was not going to let me put something else on her plate. Especially something she was convinced would never work for her students. Week after week I went into her classroom, dragged all the AAC devices out of the backpacks, talked to the paraprofessionals who worked with the students, and made observations and suggestions for the teacher. Week after week she nodded and then promptly ignored me. This continued for the entire school year until one day in the spring I went into the classroom, and she greeted me (shocking! She usually ignored me). She told me that the day before one of the students who was mostly non-verbal initiated communication with her using his device to say something he had not been taught. It was totally spontaneous, and he was able to get his message across. She even said something like, “I never thought he’d be able to do something like that.” Hallelujah! I almost did a back flip. It was the teeniest of wins, but totally worth the months of effort to get there.
Many years later, I was working with a new client on getting a device. We trialed devices, and I submitted to her insurance company to fund the device. When you do that, you have to get a prescription signed by the child’s pediatrician. It just so happens that my client’s pediatrician was the mother of a former client of mine who used AAC. She signed the prescription form and sent it back to me. A few days later she called me. She told me she wanted to let me know how much of a difference her son’s AAC device had made in his life. His birthday was just a few weeks prior, and he was able to go to his device and tell her exactly the kind of cake he wanted and what presents he wanted. She was thrilled! Needless to say, I was in tears thinking about how far this client had come in the 3 years he had been using his device. I think about this story a lot when I am feeling like my clients aren’t progressing “fast enough.”
These little wins don’t happen all the time, but when they do it reminds me why I do this crazy thing called AAC.
I have a confession to make…when I took the AAC class in graduate school I hated it. I thought the technology was big and clunky (which back in the day it really was), the programming of devices was difficult (not untrue), and that as SLPs we really should focus on getting people to talk not use a machine (Eek! Can’t believe I thought this!). How naïve I was. How judgmental, how green. Fast forward to 3 years later when I was offered a job as an AAC specialist with a local ESD with barely any AAC training or experience. Not sure how I pulled that one off! I am good in an interview 😉. I took the job because I was wanting something to specialize in, and here was my opportunity.
Looking back on that time now, I marvel at my courage and my stupidity! It was 9 months of terrifying, and exhilarating, learning on the go. My adrenaline was in constant flow as I rushed around from school to school pretending to be an AAC specialist. I spent days pouring over device manuals, trying, and failing to program all the different devices I was supposed to be an “expert” on, and working with students and teachers on how to use devices in the classroom. I made a ton of mistakes, but in the “sink or swim” situation I had jumped into, I learned to swim and came to love AAC in the process.
I know AAC can be daunting. The plethora of devices to choose from is overwhelming. The software is continuously changing, and it can be difficult to get buy in from others on the team. Other common obstacles include overflowing caseload numbers and precious little time to commit to learning something that requires dedication and continued attention. That’s why you need to support of people like me who have come before you, fallen in the pit, climbed back out, and see the amazing things that AAC can offer to individuals with communication challenges. The truth is you can’t do it all by yourself. Sometimes you need to enlist the help of others who have guidance to share. That’s why I’m here. I am dedicated to helping you get your AAC questions answered whether it relates to devices, software, goal writing, treatment planning, or engaging the client or the team.
Let’s start a conversation about AAC. What areas of AAC are most challenging for you now? Where do you see room for growth?
I have been "doing" AAC for the bulk of my career. Along the way I have encountered situations that made my blood boil, humbled me, saddened me, and inspired me. I have also spent A LOT of time trying, failing, picking myself back up, and trying again. My goal is to share about the lessons I've learned and the people I have met along the way.